Health Care Costs in Retirement: What CSX Employees Should Know Before It’s Too Late

Healthcare Provider Update: Healthcare Provider for CSX: CSX Corporation has partnered with Aetna, a division of CVS Health, to provide healthcare benefits for its employees. This collaboration allows CSX employees access to a wide range of health services and insurance plans tailored to meet their specific needs. Potential Healthcare Cost Increases in 2026: In 2026, CSX and its employees may face significant healthcare cost challenges, as the landscape for health insurance is set to experience considerable changes. With proposed premium hikes in the Affordable Care Act marketplace reaching as much as 66% in some states, the potential expiration of enhanced federal premium subsidies may exacerbate out-of-pocket expenses for many enrollees. A forecast indicates that over 22 million individuals could see their premiums increase by more than 75%, driven by rising medical costs and insurers' aggressive rate adjustments. This surge in costs could create financial strain not only for individual employees but also for the company's overall healthcare budget, necessitating strategic planning and proactive measures for 2026. Click here to learn more

'CSX employees should treat rising health care costs as a central part of retirement planning, not an afterthought, by integrating realistic medical expense projections into their overall financial strategy early on.' — Michael Corgiat, a representative of The Retirement Group, a division of Wealth Enhancement.

'CSX employees who factor health care inflation into their long-term retirement plan can better maintain financial stability and flexibility throughout their later years.' — Brent Wolf, a representative of The Retirement Group, a division of Wealth Enhancement.

In this article, we will discuss:

1. The rising cost of health care in retirement and its impact on long-term outcomes for your finances.

2. Strategies CSX employees can use to estimate and manage future medical expenses.

3. Smart ways to integrate health care planning into your overall retirement strategy.

You’ve been saving, working, and planning your retirement for decades. Yet many CSX employees are still surprised by one expense that can quietly disrupt even the most careful plans: health care.

Even if your mortgage is paid, your pension elections are set, and your retirement travel mapped out, health care costs can alter your financial path if not taken into account early.

According to Wealth Enhancement financial adviser Kevin Won, CFP®, “Health care inflation is the hidden tax on retirement. People often budget carefully for living expenses and travel, but underestimate the long-term costs of health and longevity.”

The Price of Health Care in Retirement

Industry research shows the average 65-year-old couple may need roughly $345,000 to cover premiums, prescriptions, and out-of-pocket expenses in retirement—not including long-term care. ¹  Depending on health and lifespan, total costs could reach higher amounts. For CSX retirees, these expenses can reduce decades of pension and 401(k) savings if not addressed appropriately.

Between 1989 and 2019, prescription drug prices surged over 200%, and hospital care costs climbed about 450%, far outpacing general inflation. ²  This reinforces the need for CSX employees to plan for the future cost of medical care well before retirement.

Why Estimating Health Care Costs Is So Difficult 

Everyone’s retirement health story is different, but several key factors shape expenses:

Life Expectancy
Many Americans now live well into their 80s. For CSX couples retiring at 65, there’s nearly a high chance at least one partner will live past 80 ³ —meaning additional years of premiums and prescriptions.

Personal Health
Even retirees in good health will face costs for age-related procedures, such as joint replacements, dental, and vision care. As Won notes, “Being healthy gives you choices, but not immunity from medical costs.”

Location
Where you live after leaving CSX can have a major impact. Medical procedures may vary by tens of thousands of dollars depending on the state or region.

Insurance Options
Medicare provides core coverage, but it doesn’t cover everything. CSX retirees who transition from company health benefits should understand that dental, vision, and long-term care are excluded from Original Medicare (Parts A and B).

The Ongoing Trend of Medical Inflation

Medical costs continue to rise faster than general inflation. While new technology improves outcomes and longevity, it also increases expenses. For CSX retirees living on fixed pensions, this trend can place pressure on household budgets over time.

Won cautions, “The challenge isn’t today’s prices—it’s tomorrow’s uncertainty. Retirees who base planning on current medical costs may face shortfalls in 10 to 15 years.”

Turning Concern into Control

You may not influence the health care system, but you can influence your preparation. CSX employees can start by estimating their current expenses—including out-of-pocket costs, copays, and premiums—and using an annual health care inflation rate of 5–6% to model potential future needs.

Regularly review your insurance coverage, including any CSX retiree medical benefits you qualify for, and adjust as plans and costs change. Flexibility is essential—having a buffer is better than facing a shortfall during retirement.

Smart Strategies for Paying Health Care Costs

1. Understand Medicare Coverage ⁴

• Part A: Covers hospital stays, usually with no premiums but with deductibles.

• Part B: Covers outpatient care with monthly premiums and copays.

• Part D: Offers prescription coverage through private insurers.

• Part C: (Medicare Advantage): May include dental and vision benefits.

2. Account for Long-Term Care
About 70% of retirees will need some form of long-term care. ⁵  Costs can range from $70,000 to $75,000 annually for assisted living. ⁶  CSX retirees should consider long-term care insurance or hybrid life policies, since Medicare does not cover custodial care.

3. Use Health Savings Accounts (HSAs)
Employees enrolled in a high-deductible health plan can fund HSAs with triple tax benefits: tax-deductible contributions, tax-free growth, and tax-free withdrawals for qualified medical expenses. After age 65, funds may be applied to Medicare premiums and dental or hearing costs.

4. Keep a Medical Emergency Fund
Set aside six to 12 months of medical expenses to handle dental implants, surgeries, or out-of-network care. This helps avoid liquidating investments during market downturns.

5. Balance Your Investments
Health care inflation often exceeds overall inflation. A mix of growth and income investments can help CSX retirees preserve purchasing power and maintain cash flow for health needs.

6. Review Prescription Options
Compare prices between pharmacies, consider mail-order services, and choose generic medications when available to reduce costs.

7. Include Health Care in Your Income Strategy
Treat health care as a fixed expense in your retirement budget. “When health care becomes part of your income plan, it can stop being a source of fear,” says Won.

8. Stay Informed Without Overreacting
Laws and benefits change frequently. Focus on what you can control—your savings rate, coverage selections, and plan reviews.

Your Health and Finances Are Connected

A well thought-out health care strategy can support both your wealth and your peace of mind. Whether you’re still working at CSX or approaching retirement, now is the time to strengthen your plan.

“This is the stage where your preparation pays off,” says Won. “We want health care to be part of your retirement story, not a surprise ending.”

How The Retirement Group Can Help

Health care planning doesn’t have to be overwhelming. The Retirement Group can assist CSX employees in designing a customized retirement and health care strategy aligned with their goals and benefit options. To speak with a retirement planning consultant about your pension, 401(k), or health care choices, call (800) 900-5867.

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Sources:

• 1. Fidelity Investments. ' Fidelity Investments Releases 2025 Retiree Health Care Cost Estimate ,' July 30, 2025.

• 2. Rakshit, Shameek, Emma Wager, Paul Hughes-Cromwick, Cynthia Cox, and Krutika Amin.  “How Does Medical Inflation Compare to Inflation in the Rest of the Economy?”  Peterson-KFF Health System Tracker, 2 Aug. 2024,  www.healthsystemtracker.org/brief/how-does-medical-inflation-compare-to-inflation-in-the-rest-of-the-economy/ .

• 3. Social Security Administration. ' Actuarial Life Table .' Period life table, 2022, as used in the 2025 Trustees Report.

• 4. Centers for Medicare & Medicaid Services.  “What’s Not Covered?”  Medicare.gov, 6 months ago (access date Oct. 30, 2025),  www.medicare.gov/providers-services/original-medicare/not-covered .

• 5. Administration for Community Living.  “How Much Care Will You Need?”  U.S. Dept. of Health & Human Services, 18 Feb. 2020 (page updated), acl.gov/ltc/basic-needs/how-much-care-will-you-need.

• 6. Where you live matters. ' How Much Does Assisted Living Cost? ' May 13, 2025.